The worldwide incidence of tuberculosis (TB) is rising and is linked to immigration patterns and the rise in incidence of HIV. Extra-pulmonary disease, in particular, can lead to diagnostic dilemmas. Because the total...The worldwide incidence of tuberculosis (TB) is rising and is linked to immigration patterns and the rise in incidence of HIV. Extra-pulmonary disease, in particular, can lead to diagnostic dilemmas. Because the total number of cases of TB in pregnancy in developed countries is small and often concentrated in specific urban areas with large immigrant populations, clinicians may rarely encounter the problem. This paper provides actual clinical experience of one recent case.展开更多
Here we present an unusual case of an epithelial implantation cyst within the orbit which presented 40 years after initial injury from an airgun pellet. A retrospective review of the case was performed. This case high...Here we present an unusual case of an epithelial implantation cyst within the orbit which presented 40 years after initial injury from an airgun pellet. A retrospective review of the case was performed. This case highlights the importance of taking a thorough history when assessing adnexal lesions of undetermined origin.展开更多
<strong>Intro/background:</strong> The NHS Long term plan calls for “digital-first” solutions, however, many good innovations fail. Barriers to digital innovation in healthcare are well-rehearsed and oft...<strong>Intro/background:</strong> The NHS Long term plan calls for “digital-first” solutions, however, many good innovations fail. Barriers to digital innovation in healthcare are well-rehearsed and often predictable. This paper aims to highlight issues to be considered in implementation. <strong>Methods: </strong>It is a qualitative study of experiences of telehealth implementation. <strong>Findings:</strong> Staff engagement is crucial to acceptance;compatibility with existing practises helps but where impossible, pathway redesign is necessary. There is a notion that staff of any grade can become digital champions, yet the role is challenging for staff without power. Funding systems can restrict adoption due to associated savings impacting elsewhere in the system. Organisational support for innovation is often apparent but does not trickle down to service level sufficiently. <strong>Conclusions:</strong> Senior management needs to lead on and support at a micro level the implementation of digitally enabled health care. Funders and commissioners need to recognise that innovation takes time and that measured approaches are more successful.展开更多
文摘The worldwide incidence of tuberculosis (TB) is rising and is linked to immigration patterns and the rise in incidence of HIV. Extra-pulmonary disease, in particular, can lead to diagnostic dilemmas. Because the total number of cases of TB in pregnancy in developed countries is small and often concentrated in specific urban areas with large immigrant populations, clinicians may rarely encounter the problem. This paper provides actual clinical experience of one recent case.
文摘Here we present an unusual case of an epithelial implantation cyst within the orbit which presented 40 years after initial injury from an airgun pellet. A retrospective review of the case was performed. This case highlights the importance of taking a thorough history when assessing adnexal lesions of undetermined origin.
文摘<strong>Intro/background:</strong> The NHS Long term plan calls for “digital-first” solutions, however, many good innovations fail. Barriers to digital innovation in healthcare are well-rehearsed and often predictable. This paper aims to highlight issues to be considered in implementation. <strong>Methods: </strong>It is a qualitative study of experiences of telehealth implementation. <strong>Findings:</strong> Staff engagement is crucial to acceptance;compatibility with existing practises helps but where impossible, pathway redesign is necessary. There is a notion that staff of any grade can become digital champions, yet the role is challenging for staff without power. Funding systems can restrict adoption due to associated savings impacting elsewhere in the system. Organisational support for innovation is often apparent but does not trickle down to service level sufficiently. <strong>Conclusions:</strong> Senior management needs to lead on and support at a micro level the implementation of digitally enabled health care. Funders and commissioners need to recognise that innovation takes time and that measured approaches are more successful.
